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Int. J. Environ. Res. Public Health 2016, 13(10), 1003;

The Impact of Secondhand Smoke Exposure on Children with Cystic Fibrosis: A Review

Section of Pediatric Pulmonology, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Center for Microbial Pathogenesis, The Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA
Paediatric Environmental Health Specialty Unit, Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, Murcia 30120, Spain
Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Baltimore, MD 20205, USA
Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
Section of Ambulatory Pediatrics, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Author to whom correspondence should be addressed.
Academic Editors: Laura L. Jones and Amanda Farley
Received: 5 August 2016 / Revised: 7 October 2016 / Accepted: 7 October 2016 / Published: 12 October 2016
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
Full-Text   |   PDF [285 KB, uploaded 12 October 2016]


Secondhand smoke exposure (SHSe) has multiple adverse effects on lung function and growth, nutrition, and immune function in children; it is increasingly being recognized as an important modifier of disease severity for children with chronic diseases such as cystic fibrosis (CF). This review examines what is known regarding the prevalence of SHSe in CF, with the majority of reviewed studies utilizing parental-reporting of SHSe without an objective biomarker of exposure. A wide range of SHSe is reported in children with CF, but under-reporting is common in studies involving both reported and measured SHSe. Additionally, the impact of SHSe on respiratory and nutritional health is discussed, with potential decreases in long-term lung function, linear growth, and weight gain noted in CF children with SHSe. Immunologic function in children with CF and SHSe remains unknown. The impact of SHSe on cystic fibrosis transmembrane conductance regulator (CFTR) function is also examined, as reduced CFTR function may be a pathophysiologic consequence of SHSe in CF and could modulate therapeutic interventions. Finally, potential interventions for ongoing SHSe are delineated along with recommended future areas of study. View Full-Text
Keywords: tobacco; cystic fibrosis; pediatric tobacco; cystic fibrosis; pediatric
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Kopp, B.T.; Ortega-García, J.A.; Sadreameli, S.C.; Wellmerling, J.; Cormet-Boyaka, E.; Thompson, R.; McGrath-Morrow, S.; Groner, J.A. The Impact of Secondhand Smoke Exposure on Children with Cystic Fibrosis: A Review. Int. J. Environ. Res. Public Health 2016, 13, 1003.

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